Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II.

Details

Serval ID
serval:BIB_8AFB4F82172E
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II.
Journal
Journal of the European Academy of Dermatology and Venereology
Author(s)
Wollenberg A., Barbarot S., Bieber T., Christen-Zaech S., Deleuran M., Fink-Wagner A., Gieler U., Girolomoni G., Lau S., Muraro A., Czarnecka-Operacz M., Schäfer T., Schmid-Grendelmeier P., Simon D., Szalai Z., Szepietowski J.C., Taïeb A., Torrelo A., Werfel T., Ring J.
Working group(s)
European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS)
ISSN
1468-3083 (Electronic)
ISSN-L
0926-9959
Publication state
Published
Issued date
06/2018
Peer-reviewed
Oui
Volume
32
Number
6
Pages
850-878
Language
english
Notes
Publication types: Letter
Publication Status: ppublish
Abstract
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease-modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen-specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress-induced exacerbations. Therapeutic patient education ('Eczema school') is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline.
Keywords
Adult, Allergens/toxicity, Anti-Infective Agents/therapeutic use, Anti-Inflammatory Agents/therapeutic use, Child, Consensus, Dermatitis, Atopic/diet therapy, Dermatitis, Atopic/drug therapy, Dermatitis, Atopic/microbiology, Dermatitis, Atopic/therapy, Dermatologic Agents/therapeutic use, Eczema/diet therapy, Eczema/drug therapy, Eczema/microbiology, Eczema/therapy, Europe, Humans, Immunosuppressive Agents/therapeutic use, Immunotherapy, Patient Education as Topic, Practice Guidelines as Topic
Pubmed
Web of science
Open Access
Yes
Create date
25/06/2018 10:56
Last modification date
20/08/2019 14:49
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